I trained in Medicine at the Middlesex Hospital in London, then specialized in Psychiatry and Clinical Epidemiology. I have worked in various positions in London, Botswana and Australia. I spend thirty years as a working psychiatrist, but in the last two decades I have concentrated on health service analysis, monitoring and improving healthcare safety and quality, and healthcare process redesign using Lean Thinking techniques. I have had an active career as a clinical researcher, and have published over 100 articles in the peer reviewed literature, as well as three books.